| Title |
Knowledge is not enough to solve the problems – The role of diagnostic knowledge in clinical reasoning activities
|
|---|---|
| Published in |
BMC Medical Education, November 2016
|
| DOI | 10.1186/s12909-016-0821-z |
| Pubmed ID | |
| Authors |
Jan Kiesewetter, Rene Ebersbach, Nike Tsalas, Matthias Holzer, Ralf Schmidmaier, Martin R. Fischer |
| Abstract |
Clinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown. Medical students (n = 21) were exposed to three different clinical cases and instructed to use the think-aloud method. The recorded sessions were transcribed and coded with regards to the four different categories of diagnostic knowledge (see above). The transcripts were coded using the frequencies and time-coding of the categories of knowledge. The relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods. The use of metacognitive knowledge is correlated with application of conceptual, but not with conditional and strategic knowledge. Furthermore, conceptual and strategic knowledge application is associated with longer time on task. However, in contrast to cognitive action levels the use of different categories of diagnostic knowledge was not associated with better diagnostic accuracy. The longer case work and the more intense application of conceptual knowledge in individuals with high metacognitive activity may hint towards reduced premature closure as one of the major cognitive causes of errors in medicine. Additionally, for correct case solution the cognitive actions seem to be more important than the diagnostic knowledge categories. |
X Demographics
The data shown below were collected from the profiles of 10 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 30% |
| United States | 2 | 20% |
| Denmark | 2 | 20% |
| Kenya | 1 | 10% |
| Unknown | 2 | 20% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 60% |
| Practitioners (doctors, other healthcare professionals) | 3 | 30% |
| Scientists | 1 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 107 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Unknown | 106 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 11% |
| Student > Doctoral Student | 12 | 11% |
| Lecturer | 9 | 8% |
| Professor > Associate Professor | 9 | 8% |
| Researcher | 8 | 7% |
| Other | 33 | 31% |
| Unknown | 24 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 46 | 43% |
| Nursing and Health Professions | 9 | 8% |
| Social Sciences | 7 | 7% |
| Psychology | 4 | 4% |
| Arts and Humanities | 3 | 3% |
| Other | 11 | 10% |
| Unknown | 27 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 November 2017.
All research outputs
#5,176,038
of 25,539,438 outputs
Outputs from BMC Medical Education
#915
of 4,017 outputs
Outputs of similar age
#92,194
of 416,363 outputs
Outputs of similar age from BMC Medical Education
#14
of 50 outputs
Altmetric has tracked 25,539,438 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,017 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has done well, scoring higher than 77% of its peers.
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We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.